Osteoarthritis of the knee (gonarthrosis)

Osteoarthritis of the knee joint (also called gonarthrosis) is a fairly common disease that has recently been found not only in the elderly but also in young people.

Pathology is one of the main causes of injury to patients if they refuse to seek help from a traumatologist or orthopedist.

Let's look at why patients develop gonarthrosis of the knee joint, what are its main signs, how dangerous it is and how effective is the treatment of progressive destruction of the knee.

The main factors for the appearance of this pathology

The joints are constantly exposed to significant stress. The knees are particularly affected: they are forced to perform significant physical work, which is why they wear out quickly. The process of deformation is exacerbated by the fact that the legs are forced to bear the weight of the body.

This fact further contributes to the fact that the knees begin to wear out and the cartilage of the joint becomes thinner and degrades.

The following causes can accelerate the pathological process in the joints:

1. Increased body weight of patients. With complete destruction of the joint it becomes much faster and more intense. It has been shown that the disease in question is three times more common in obese people than in normal weight people.
2. Intense sports that cause injuries to the joints all the time.
3. Frequent fractures, previous knee injuries contribute to the fact that the patient begins to degenerate the processes of articular cartilage from a relatively young age.
4. Abnormalities in the location of the bones - the so-called valgus or varus deformity.
5. Poor development of the ligament apparatus of the knee leads to frequent injuries, dislocations. Due to the described injuries, the patient develops osteoarthritis.
6. Damage to the meniscus triggers the degenerative process of destruction of the knee.
7. Constant stress leads to deterioration of the health of the musculoskeletal system.
8. Disruption of metabolic processes in the body due to lack of nutrients and minerals (bones suffer the most from lack of calcium).

In addition, the following people belong to the risk group:

• all athletes;
• patients, regardless of gender, who have reached the age of 50;
• women who have started menopause;
• patients suffering from varicose veins;
• persons with unfavorable heredity.

What are the degrees of the disease

The pathology in question develops gradually, very slowly. It may not appear at first and the patient is in no hurry to see a doctor. However, the pathological process has already begun and if it is not stopped in time, the functions of the lower extremities will be gradually lost, leading to disability.

So in grade 1, the patient may notice that the leg gets tired, even if the load is low. There is some limitation in the mobility of the knee joint and a significant crunch is heard during movement.

There is a pronounced initial pain when the discomfort does not give rest mainly in the morning. After the patient "disperses", the discomfort gradually subsides, increasing again after sports activities. At this stage of the disease there is no pronounced deformation of bone tissue.

In grade 2, the pain worsens. Walking is difficult because of this. Sometimes it becomes almost impossible for the patient to move normally and even after a light load a long rest is needed. As the joint space narrows, osteophytes grow on the bones and pathological fluid builds up in the joint.

In grade 3 pain occurs not only during work, sports, but also in a state of complete rest. The deformity of the knee is very pronounced, which makes any movement difficult.

Common symptoms of the disease

It is necessary to pay attention to the general symptoms of osteoarthritis of the knee:

1. Pain. It does not appear suddenly, but the mild discomfort can last for almost years. The more severe pain is caused by trauma.
2. Deformity of the knee (retains its previous shape).
3. Accumulation of fluid in the intra-articular cavity. When its amount exceeds certain values, the so-called Baker's cyst develops. A tight elastic object appears at the back of the knee. It is most noticeable when the joint is extended.
4. Crunching of the knee is observed if the pathology is in the second, third stage. It differs significantly from that observed in a healthy person when bending or stretching the knee. The sound feels harsh and painful. Sometimes crunching interferes with active movements.
5. Reduced normal range of motion in the joint. Usually the patient cannot bend, unfold the affected leg. He is able to bend it at right angles, further movements are accompanied by severe pain.
6. Knee stiffness occurs mainly in stage 3. Sometimes patients can walk only on bent limbs.
7. Increased pain with changing weather.
8. Significant thinning of cartilage. Occasionally, in advanced cases, bone exposure is noted. An X-ray of the knee shows a significant accumulation of osteophytes.

Varieties of osteoarthritis

Depending on the origin, osteoarthritis is primary (occurs as a separate disease) or secondary - a complication of existing pathologies. Depending on the location, the pathology is right-, left- and bilateral.

Based on the characteristics of the manifestation, the following types of disease are distinguished.

1. Deforming arthrosis is characterized by a chronic course, irreversible changes in the joint.
2. Patellofemoral osteoarthritis develops due to prolonged intense physical activity.
3. Inflammatory osteoarthritis occurs due to prolonged untreated inflammatory process in the joints.
4. Dysplastic arthrosis develops due to congenital anomalies in the structure of the knee joint.
5. Post-traumatic osteoarthritis occurs as a result of frequent injuries to the musculoskeletal system.
6. Metabolic osteoarthritis occurs with gout and other metabolic disorders.
7. Post-infectious osteoarthritis occurs as a result of insufficiently treated inflammatory pathologies.
8. The static form of the disease is detected when the knees are constantly exposed to increased pressure.
9. If the cause of the knee lesion is not identified, experts talk about idiopathic osteoarthritis.

Characteristics of the treatment of the disease

In the initial stages of the disease, a rheumatologist and a traumatologist are involved in the treatment. If it has gone too far, the patient should consult a surgeon. Finally, in some clinics there is a narrow specialist dealing with joint diseases - an arthrologist.

The scope of therapeutic measures depends on how far the disease has progressed. If it is possible to eliminate the cause of the pathology in question in the early stages, then almost permanent recovery can be achieved.

The goals of any therapy are the complete elimination of pain, the restoration of damaged cartilage and increasing the range of active movements in the joint.

The course of drug treatment is chosen exclusively by a physician. The patient cannot prescribe them because this can contribute to further destruction of the joint. The main drugs are prescribed:

1. Non-steroidal anti-inflammatory tablets or ointments. Their action is aimed at relieving pain, inflammation in the affected area. Injections into the joint cavity may sometimes be prescribed.
2. Products that improve blood circulation in the knee. These are muscle relaxants, antispasmodics. The latter relieve pain well.
3. Products that restore articular cartilage improve normal nutrition in it.

Novocaine blockade helps relieve acute pain. The injection can be done from the outside or inside of the joint. The simplest and safest method is to apply the drug externally. With proper manipulation, the pain disappears almost immediately.

Ointment based on powerful NSAIDs also helps to cope with pain. It should be remembered that you should not use strong drugs for a long time. Any drug, even the most effective, can have side effects and cause allergic reactions. This means that self-treatment of this serious disease is strictly prohibited.

Conservative treatment can be effective, provided the disease has not gone too far. In case of irreversible damage to the joint, surgery is indicated. Metal prosthesis is implanted.

Currently, this is the only way to restore knee mobility. The disadvantages of these operations are the limited service life of the prosthesis, the high cost.

In arthroscopy, all surgical procedures are performed by performing microscopic punctures in the joint. During the operation, the affected cartilage fragments, clots, etc. are removed from the joint. In stage 3 of the disease, the type of intervention described is ineffective.

Periarticular osteotomy is used to reduce the load. It has been shown to be done when the joint is not yet completely destroyed.

Canes and orthoses are used to unload the joint affected by the degenerative process.

The duration of treatment of the disease depends on many factors. The course of therapy with chondroprotectors can be quite long - six months or even more, as the effect of them is quite slow. A qualified healthcare professional can determine how long you should take your prescribed medication.

The use of chondroprotectors in the treatment of osteoarthritis

To relieve pain, doctors prescribe nonsteroidal anti-inflammatory drugs (NSAIDs).

However, even new generation NSAIDs cannot prevent the spread of the pathological process. Chondroprotectors are increasingly being used to reduce the intensity of joint degeneration and restore normal mobility.

Modern drugs in this group help to restore joint tissue. This is due to the content of chondroitin in them. It is a natural component of cartilage. Constant intake of drugs from this group helps to recover, improve health.

Despite the wide range of drugs available, only a doctor can determine which one is right for a patient. The injection of chondroprotectors is not shown at all, the drugs themselves are diluted in special solvents.

Taking nutritional supplements is indicated if the patient follows the rules of a balanced diet, taking other drugs to maintain joints.

The role of physical therapy and physiotherapy in the treatment of gonarthrosis

With the described pathology the patient is categorically contraindicated in a supine lifestyle. Physical activity for any disease of the musculoskeletal system is simply necessary for all categories of patients. Of course, it must be dosed; each exercise is performed exclusively under the supervision of a physician.

For each patient traumatologist or rehabilitation therapist selects individual special exercises. You don't have to think that the different sets of classes that can be found on the Internet will suit all patients without exception.

For some they can be really useful, while for others they will do great harm. All loads should be gentle, aimed at the fastest and most complete recovery of the functions of the affected joints.

At home, it is recommended to perform a simple exercise: while lying down, raise your leg, hold it for a few minutes and then lower it. It is harmless and can be performed even by patients with stage III disease. Exercises to stretch the joint capsule are performed under the supervision of a doctor. But if it causes pain, then the performance should be stopped immediately.

Physiotherapeutic methods of treating the disease include:

• massage (it is strictly forbidden to do without a doctor's indication);
• manual therapy (should be as gentle as possible, not to cause discomfort);
• medical laser treatment;
• impact on reflex points with the help of the finest needles;
• heat or cold treatment (again, it is not necessary to perform thermal procedures at home);
• magnetic field treatment;
• phonophoresis;
• electrophoresis;
• paraffin therapy;
• ozokerite treatment;
• moxibustion with wormwood.

Nutrition for gonarthrosis

Proper nutrition is the basis of successful treatment of degenerative diseases of the musculoskeletal system. Due to improperly formulated diet, the patient may gain weight. Lack of vitamins, trace elements worsens the course of pathology.

All people with gonarthrosis should increase the amount of foods fortified with vitamins and minerals in their daily diet.

Nutritionists recommend carefully monitoring the calorie content of food. Fasting or extreme diets are strictly forbidden. They can be harmful, body weight will increase even more.

It is imperative to ensure that breakfast is balanced. You should eat at least five times a day. For snacks it is recommended to use fruit, bread.

The following foods and dishes are excluded:

• sweet soda;
• fatty dishes;
• semi-finished products;
• spices;
• Dishes containing flavor enhancers;
• fatty meats;
• fried foods;
• White Cabbage;
• tomatoes and peppers;
• oranges, lemons;
• chocolate;
• bananas, grapes (they are very high in calories).

Jelly meat and jelly are useful. They contain a large amount of collagen, thanks to which bones are restored. Jelly meat is prepared so that it contains less fat, so the calorie content will be reduced.

Sources of protein for those suffering from osteoarthritis can be dairy products - cheese, cottage cheese or kefir. It is very useful to consume legumes. Be sure to include nuts in your diet.

It is necessary to follow the drinking regime. Provided that there are no concomitant kidney diseases, it is recommended to consume about 2 liters of water.

On alternative treatments for the disease

It should be remembered that traditional methods cannot replace effective methods of official medicine. Therefore, they should be used in complex treatment, there can be no other therapy for this serious disease.

To relieve swelling of the knee, use plain soda. The fabric is moistened with soda slurry and wrapped around the knee. Above, to improve the thermal effect, it is recommended to attach a plastic bag. Store the finished compress overnight.

Such a compress is made by adding food vinegar. Acetylsalicylic acid tablets should be taken in parallel with the application of compresses.

Burdock leaves are very useful for the knee. Before applying the leaves, it is recommended to lubricate the knee with vegetable oil. It is necessary to have several layers of leaves.

All this is packed in a plastic bag. In the same way compresses are made with birch leaves.

Medicinal bile well relieves inflammation, swelling and pain. It is used in the form of warming compresses at night. Bile has virtually no side effects.

Honey treatment is performed in cases where the patient is not allergic to it. After the diseased joint is warmed with a heating pad, it should be smeared with honey and a light massage. Then attach the burdock leaf to the knee.

Prevention of gonarthrosis

Preventing the disease is much easier than curing it. Prevention measures include:

• high-quality, balanced diet using sufficient amounts of protein, vitamins and calcium;
• elimination of bad habits;
• the fight against overweight;
• normalization of physical activity;
• prevention of joint injuries during sports or heavy physical work.

When the first symptoms of the disease appear, it is important to see a doctor immediately. During a consultation in a clinic, it is possible to find out which doctor treats gonarthrosis. It is advisable to undergo a comprehensive medical examination to understand the cause of the disease.

Osteoarthritis of the knee is a serious disease: if neglected, there is a risk of injury and complete immobility. To prevent this, you need to properly treat the affected joint. Early therapeutic measures contribute to the almost complete remission of this pathology, help maintain high productivity, quality of life.